Thursday, June 09, 2011

Prior to her celebrity status, she spent many years working with eating disordered patients and her doctoral thesis was on, "The Effects of an Eight Week Intuitive Eating Program on Eating Disordered Participants", and she reports that eating disorders are still part of her practice on her official biography.

While I know Dr. Berman recognizes many of the complexities of obesity in modern society, the average Joe/Jane doesn't. They don't think about the psychology of eating, socio-economics, co-morbid medical problems, predatory advertising, environmental obesogens, genetics, the cheap costs of calories, food hyperpalatability, lack of proper nutritional education in our schools, etc., etc. To them, societal obesity is a consequence of us spending too much time eating our proverbial, "chocolate sandwiches". They think it's all about laziness and gluttony, and that parents, "just saying no" and willpower would make this all go away. Though certainly not intentionally, Dr. Berman's tweet reinforced that message.

Given Dr. Berman's professional pedigree, I highly doubted that she meant for her tweet to be taken the way I've spun it above, so I contacted her via Twitter where she replied that was certainly not her intention.

That said, I wonder what her eating disordered patients, some of who also likely struggle with obesity, would think of her tweet, given that without a doubt many of them have seen their struggles amplified by health professionals who've callously and ignorantly, attributed their weights to the consequence of simply eating too many "chocolate sandwiches".

So why am I bothering with this post? Well maybe I'm over-reacting, but according to TweetReach, Dr. Berman's tweet reached nearly 200,000 people, and while certainly some may have taken that comment to be innocent, others certainly had it fuel their own ill-informed biases.

Given her profile, I'm guessing Dr. Berman's tweets carry more weight than the average, and here's hoping that she, and all of us who are enamored with 140 character updates, will remember to think about how those 140 characters might be interpreted before we tweet.

8 comments:

I agree with you. My son would eat chocolate sandwiches all he wanted (if I let him) and he would still be thin. The reason he doesn't get them is because I also care about his health, and weight is not necessarily always an indication of it.

Interesting. As a lay person, I tend to associate eating disorders with people who are thin (the classic anorexic), even though it's obvious to me that the bigger issue is the large number of people with eating disorders or disordered eating who do not fit that classical profile. (How many obese people go on the starvation diets of those with anorexia nervosa, but are undiagnosed because their BMIs remain over 30? Can it be argued that post-operative bariatric-surgery patients must conform to a diet that, absent the initial obesity or the surgery, might be considered consistent with anorexia nervosa?) Of course, that's just anorexia -- people dealing with disordered-eating behaviors such as bulimia, binge eating, and so on may not present the stereotypical physical images that are a large part of the diagnosis.

Regardless of whether the cause is sociopolitical, socioeconomic, or other, until we as a society view "not-cooking-in" as the aberrant eating behavior, and regardless of other contributing factors, institutional obesity is likely to progress.

I hate it when people judge others like that. You never know the whole story.

How does Dr. Berman know the "chocolate sandwich" (does that mean Nutella or something?) wasn't a special treat that the boy was promised, something that he rarely has? How does she know the mother isn't doing the best she can under very difficult circumstances? Maybe she grew up in poverty and never learned about cooking, about nutrition. Maybe she is overworked and frazzled to the limit, and just this once decided to prepare a snack with ingredients she had on hand, rather than chop up veggies and get into a fight to try to get him to eat celery sticks. Maybe she is clinically depressed and her energy and motivation are low-to-nonexistent. Maybe the family's diet is very healthy overall, consisting of 80% vegetables, fruits, whole grains, lean protein, and this is the occasional treat that falls into the 20%.

So many things could be going on here. By coming across as so judgmental, what effect does Dr. Berman have on those people who do occasionally have a "chocolate sandwich"? Those people whose relationship with food is so fraught with emotion. Those people who already feel judged by strangers in the lineup at the supermarket. Those people who have internalized the shame that society is sending them about their food choices and about their bodies.

My entire family grew up eating chocolate sandwiches. My dad is 70 years old and still eats them. I rarely indulged and I'm the only obese one in my family. My dad is underweight and my siblings and mom are normal weight. Comments like those made by the good doctor reinforce that obesity is something that is merely controlled by willpower. If I'm obese, it's because I just eat too much and have no control. While I expect more from people in the medical profession, her comments really don't surprise me. I really wouldn't be surprised either if they expressed how she actually feels about her obese patients.

I totally agree with the anon. poster from 9:03. I'd bet this is the general thought of most health professionals.

When my kids were small they got ONE lunchable (edible cardboard in my opinion)per YEAR. One in a year! That was the day they came home ready to chew my leg off because they were starving. I'm sure if I'd sat beside the good doctor on that day with my child celebrating because they finally had what all the other kids had I'd have been judged a poor mother too. PS. I know chocolate sandwiches MUST be on Canada's Food Guide right? All that milk and hazelnut goodness? ;)

Having read a bit of her tweet feed prior to that one tweet in particular, I see she may have been tired, cranky and frustrated with many other things, and that may have been a source of irritation that caused her to tweet from the hip an off-the-cuff thought that she should have kept to herself. But, as one who knows a bit about isolation and frustration, I understand how sometimes one can get into a flow of trying to entertain yourself so you don't go stir-crazy using Twitter, and tend to send out over the top tweets.

I don't think she meant to hurt anyone's feelings, and as a professional, Yoni, you certainly have the right to question her professionalism at all times, but as a lay person, I sorta get it... I think, and I'm gonna let this one slide. If I saw tonnes of these same statements in her feed, I'm be all over her, however, and her credibility would be shot in my eyes. As it is, I don't know her from a hole in the wall, and I going to give her the benefit of one-time pass for the passing remark.

We all make dumb, ignorant or plainly stupid, lazy comments every day. No need to send out a lynch mob. She's a mere human - like the rest of us.

I who buried someone who ate too many chocolate sandwiches all his life, beginning in childhood, think there's a problem there, and when the child is 18 and massively obese and has diabetes 2 will be too late to do something about it. Diabetes 2 drugs, treatments, heavy use of employee health plans, kidney rejection, transplant, dialysis, kidney failure, transplant drug caused cancer.

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Family doc, Assistant Prof. at the University of Ottawa, Author of The Diet Fix, and founder of Ottawa's non-surgical Bariatric Medical Institute - a multi-disciplinary, ethical, evidence-based nutrition and weight management centre. Nowadays I'm more likely to stop drugs than start them. You can also follow me on Twitter and Facebook.

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